November/December Parenting & Prevention Newsletter

When people like the headline writer of this HealthDay news article talk about “medical marijuana,” they usually mean everything. The plant’s dried flowers which people smoke. Concentrates that can contain up to 90 percent THC, whose extraordinarily high levels are almost certainly what is sending toddlers and children who accidentally consume them and adults who consume them on purpose to emergency rooms with many needing to be hospitalized. “Edibles” – cookies, candies, and soft drinks infused with marijuana that are now in the food chain. And hundreds more, all sold as “medicines.”

The HealthDay author does a good job of covering a new study in Pediatrics, the journal of the American Association of Pediatrics. But notice the study’s title: “Medical Cannabinoids – not Medical Marijuana – in Children and Adolescents: A Systematic Review.”

What’s the difference?

The marijuana plant contains about 500 different chemicals. Most have not been studied. Some 100 of those are called cannabinoids, so-called because they are unique to the cannabis plant. Most of these have not been studied either, but that is changing. Some cannabinoids show scientific promise and may become medicines. Two already are.

By medicines, we mean they have gone through rigorous preclinical (test tubes and animals) and clinical (humans) research. They have proven to FDA that they are both safe and effective, can be manufactured with a consistent dose, and most importantly are pure. They contain no contaminants unlike most of the products in legal states. A further FDA safeguard is that sometimes approved medicines cause dangerous side effects in the larger population after approval. FDA has a notification system that requires doctors to report any that occur so the medicine can be pulled from the market, if necessary.

The most studied cannabinoids are delta-9 THC and cannabidiol (CBD). The former makes people high. The latter doesn’t. The two medicines that FDA has approved are nabilone (trade name Cesamet®) and dronabinol (trade names Marinol® and Syndros®). Cesamet® and Marinol® are pills. Syndros® is an oral liquid. They are used to reduce chemotherapy-related nausea and AIDS wasting in patients who do not respond to standard medications.

Two more cannabinoids, nabiximols (trade name Sativex®, approved in other countries but not yet in the US yet) and CBD (trade name Epidiolex® which has completed clinical trials and is applying for FDA approval) are in the pipeline.

About half our medicines originated in plants. But when drug makers create a new medicine from them, they use pure chemicals to make a molecule-for-molecule carbon copy of the plant’s component. Nabilone and dronabinol are made that way. Patients know when they take these medicines that they will not contain any contaminants and FDA has approved them.

Not so the “medical” marijuana products being produced and sold in states that have legalized the drug for medical use. In fact, the American Epilepsy Society calls such CBD products “artisanal CBD” to differentiate them all from Epidiolex®, which may be available as early as next year to treat children and adolescents suffering intractable seizures.

Not one of the marijuana products states allow to be sold as medicines has been approved by FDA.

This new study searched several databases for scientific articles about pharmaceutical-grade cannabinoids that are being studied to treat a variety of illnesses in children and adolescents. The medicines used in these studies were nabilone, dronabinol, Epidiolex®, a formulation of delta-8 THC, and other pharmaceutical-grade preparations, not Charlotte’s Web, Haleigh’s Hope, Cannatol, or any of the hundreds of other artisanal CBD products states allow to be shipped – and Amazon sells – to all 50 states in violation of federal law.

The researchers found that in children and adolescents: “Evidence for benefit was strongest for chemotherapy-induced nausea and vomiting (four RCTs), with increasing evidence of benefit for epilepsy [1 RTC using Epidiolex® rather than artisanal products]. At this time, there is insufficient evidence to support use for spasticity, neuropathic pain, posttraumatic stress disorder, and Tourette syndrome.

Drew Evans, Superintendent of the Minnesota Bureau of Criminal Apprehension, says Minnesota is facing the most dangerous drug epidemic ever.

Evans said heroin laced with fentanyl, or the even more dangerous carfentanil, is a danger to Minnesotans and BCA crime scene investigators and scientists.
“I think what the public needs to know is fentanyl is extremely dangerous,” he said.
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KSTP/Kevin Doran

Evans showed KSTP what the BCA is doing to make sure nobody is killed investigating an opioid overdose.

Read more about it here

Ex-DEA agent:
Opioid Crisis Fueled by Drug Industry and Congress

Whistleblower Joe Rannazzisi says drug distributors pumped opioids into U.S. communities — knowing that people were dying — and says industry lobbyists and Congress derailed the DEA’s efforts to stop it

In the midst of the worst drug epidemic in American history, the U.S. Drug Enforcement Administration’s ability to keep addictive opioids off U.S. streets was derailed — that according to Joe Rannazzisi, one of the most important whistleblowers ever interviewed by 60 Minutes. Rannazzisi ran the DEA’s Office of Diversion Control, the division that regulates and investigates the pharmaceutical industry. Now in a joint investigation by 60 Minutes and The Washington Post, Rannazzisi tells the inside story of how, he says, the opioid crisis was allowed to spread — aided by Congress, lobbyists, and a drug distribution industry that shipped, almost unchecked, hundreds of millions of pills to rogue pharmacies and pain clinics providing the rocket fuel for a crisis that, over the last two decades, has claimed 200,000 lives.

Minneapolis authorities say a surge in people being treated for suspected overdoses of the synthetic marijuana drug K2 has spilled into the new week.
“Approximately 90 patients have been made ill by a drug that they were attempting to use for recreational purposes that they believe to be K2,” said Dr. Jon Cole, medical director of the Minnesota Poison Control System, based at Hennepin County Medical Center.

Cole said some people are brought into the hospital highly agitated, even violent in some cases, but others are almost comatose. They can have low or high blood pressure or low or high heart rates. He said they may be showing signs of kidney or heart failure, as well.

Cole said a new formulation of the drug may have caught users by surprise. that sellers have “concentrated the drug too much and people are taking what they think is their normal dose, when in fact it’s an overdose,”

The history of K2 is that K2 was initially created in research labs to mimic the active ingredients in marijuana with the hope of treating nausea and vomiting associated with chemotherapy. But the compounds became a favorite of drug dealers. K2, also known as “Spice,” started showing up in head shops in the late 2000s where it was sold as an “herbal incense blend.”

Authorities say some people buy it because they think it’s stronger and cheaper than regular marijuana; others think it will allow them to pass a drug test while using. Minnesota outlawed synthetic drugs in 2011, but they can still be found in some head shops and on the street.

Emerging Drug
Trends in 2017
News on January 5, 2017 by The River Source.

“Pink” (U-47700)
Pink, a synthetic opioid that is eight times stronger than heroin. It’s a Schedule I drug, meaning that it has a high potential for addiction and no known medical use. Over the past year, Pink has been linked with 46 confirmed deaths in New York and North Carolina. Pink is made synthetically in Chinese labs and imported to the U.S. The drug is extremely potent, even in small doses.

Carfentanil
Carfentanil is used as a sedative for large animals such as elephants. The drug is one of the strongest opioids available – approximately 10,000 times more potent than morphine. It’s also been linked to a high number of overdose deaths.

Fentanyl
The synthetic opioid is extremely powerful – 50 times stronger than heroin. Fentanyl-laced heroin was linked to an increase in overdose deaths. Counterfeit pills mixed with the drug gained attention from the DEA as well.

Synthetic Cannabinoids
Synthetic marijuana like K2 and Spice continue to be on the radar for law enforcement. These synthetic drugs can cause adverse health effects and land users in the emergency room due to extreme lethargy, suppressed breathing or agitated behavior. Though synthetic cannabinoids are sold under a number of names and made to look like “fake weed,” they are much more powerful and can lead to death in some cases.

We expect to see more of synthetic and designer drugs because of their accessibility, availability and attractive price points. However, these drugs are highly dangerous and extremely addictive. A small amount can be fatal.

America’s Teen Anxiety Epidemic is Heartbreaking. Parents, Here’s the Incredible Thing You
Must Do Now
Jeannie Cunnion, Fox News

I sat on a parenting panel last month with a well-known and widely respected counselor by the name of Sissy Goff, M.Ed, LPC-MHSP. She is the Director of Child & Adolescent Counseling at Daystar in Nashville and when asked about the biggest issue facing kids today, she confirmed what you’ve probably read about recently on your news feed or even your Facebook feed – the increasing anxiety epidemic in our country.
But it’s not just an epidemic among our kids. It’s an epidemic among us — their parents.

According to the National Institute of Mental Health, anxiety is the most common mental-health disorder in the United States, affecting nearly one-third of both adolescents and adults.

In a recent article entitled “Why Are More American Teenagers Than Ever Suffering from Severe Anxiety” we glean significant insight into the anxiety epidemic:

I’ll just share just two key points from the article:
* Privileged youths are among the most emotionally distressed young people in America. These kids are incredibly anxious and perfectionistic.

* For many of these young people, the biggest single stressor is that they never get to the point where they can say, ‘I’ve done enough, and now I can stop.’ Kids have a sense that they’re not measuring up. The pressure is relentless and getting worse.

If you’re reading this article as a mom, I imagine it breaks your heart like it breaks mine (as the mother of four boys who range in age from toddler to teenager) to learn that the pressure our kids are under “is relentless and getting worse.” Of course, I think we already assumed this to be true. But knowing it to be true leaves us responsible to do something to fight against it.
We have to be willing to take an honest (maybe painfully honest) look at how we may have contributed to the anxiety our kids feel with the pressure we just might be passing down with our unrealistic expectations and impossible standards of ourselves, and of them.

See, we parents aren’t the only ones linking accomplishment to acceptance and success to significance. Our kids are attempting to answer the question, “Is who I am enough?” by how well they perform on the field, how much they excel in school, and how many likes they get on their Instagram feed.

They are attempting to answer that question, “Is who I am enough?” by proving they can do enough and be enough. Whatever “enough” is. Because you and I both know enough is never enough when the goal is perpetual perfection.

The primary message our kids receive is that they’d better be the best at everything, and this leaves them afraid to reveal their inadequacies and insecurities—and hiding behind the best version of themselves.

In turn, parents of anxious teens feel helpless and hopeless, questioning all of the steps we are — or aren’t — taking. Our confidence as moms crumbles as we try to help our kids navigate the battles they have to fight and the mountains they have to climb.
Read the full article here

The companies that manufacture and distribute highly addictive painkillers are facing a barrage of lawsuits for the toll their product has taken on communities across the country as the worst drug epidemic in U.S. history continues to escalate.

After years of government and pharmaceutical firms failing to control the problem, some lawyers say the suits have the potential to force the industry to curb practices that contribute to it.

In addition, more than half the country’s state attorneys general — Republicans and Democrats — have banded together to investigate the industry.

Two congressional panels also are examining the industry — the Senate Homeland Security and Governmental Affairs Committee and the House Energy and Commerce Committee. The Justice Department’s inspector general is investigating why the Drug Enforcement Administration slowed enforcement efforts against drug distribution companies.

Stemming the epidemic, will take a coordinated effort by doctors, the industry, and federal and local government agencies.

“As we look to prevent abuse and misuse in the future, it will require a forward-looking, systemic approach that calls on greater coordination and collaboration between health-care, law enforcement, and state and federal regulatory authorities,” said the Healthcare Distribution Alliance, which represents companies that distribute drugs.

The lawsuits come as states and communities grapple with the economic impact of a prescription drug epidemic that has resulted in nearly 180,000 overdose deaths between 2000 and 2015 — more than three times the number of Americans who died during the Vietnam War. The epidemic has led to thousands more deaths from overdoses of heroin and fentanyl, which are becoming easier and cheaper to obtain than prescription drugs.

Manufacturers, distributors and pharmacy chains are expected to argue that they cannot be held responsible for what happens to pain pills once they travel down the supply chain.

“They ship a drug that’s approved by the FDA [Food and Drug Administration], and then a bunch of bad actors intervene — pill mills, doctors who overprescribe and the addicts themselves,” Ausness said. “It’s a pretty strong argument.”

The suits are reminiscent of the tobacco cases filed two decades ago. In the 1990s, 46 attorneys general eventually combined their resources to sue the tobacco companies. In 1998, the industry settled those suits, agreeing to pay more than $200 billion.

Woods said the similarities between the opioid and tobacco suits are striking.“They are big companies that knew their product was doing harm,” he said. “Instead of helping to solve the problem, they promoted the irresponsible use of their product to improve their bottom line.”

At the same time, prescription narcotics, when used appropriately, can eliminate pain without deadly health consequences — a claim cigarette manufacturers could not make.

The suits target some of the biggest names in the business, including McKesson, Johnson & Johnson and CVS.

Some of the suits allege that the companies fraudulently marketed opioids to the public. Others claim that the companies failed to report suspiciously large orders of prescription pain pills placed by distributors and pharmacies.

As the epidemic spreads, more states are declaring states of emergency and filing lawsuits.

In 2015, 500 people died from opioid-related overdoses, not counting heroin, and there were 30,000 opioid-related emergency room visits that same year, a 200 percent increase over the previous decade.